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Flashcards in Renal Random Facts Deck (87)
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1

What does the mesonephros become?

Men- Wolffian ducts (ductus deferens and epidydimus); Women- vestigal Gartner's duct

2

What is a multi cystic dysplastic kidney

Due to abnormal interaction between ureteric bud and metanephric mesenchyme. Leads to a nonfunctional kidney consisting of cysts and connective tissue

3

Relationship to ureter to ductus deferens

Ureters pass under the ductus deferens

4

What do the uterine vessels travel in?

Cardinal ligament

5

What is the 60-40-20 rule?

60% total body water: 40% intracellular, 20% ECF

6

How do you measure plasma volume and extracellular volume?

Plasma volume measured by radio labeled albumin, extracellular volume measured by inulin

7

Equation for renal blood flow

RBF=RPF/(1-Hct); RPF is the clearance of PAH

8

How does changing the plasma protein concentration change the GFR, RPF, and FF?

Increased plasma protein concentration decreases the GFR, doesn't affect the RPF, and therefore decreases the FF (GFR/RPF)

9

Hartnup disease

Autosomal recessive, deficiency of neutral amino acid transporters in proximal renal tubular cells and on enterocytes, causes a neutral aminoaciduria and decreased absorption from the gut

10

What is Fanconi syndrome

Generalized reabsorptive defect in PCT, associated with increased excretion of nearly all amino acids, glucose, HCO3-, and PO4(3-). May result in metabolic acidosis (proximal renal tubular acidosis)

11

Bartter syndrome

AR, affects Na/K/2Cl transporter, results in hypokalemia and metabolic alkalosis with hypercalciuria

12

Gitelman syndrome

AR, reabsorptive defect of NaCl in DCT. Leads to hypokalemia, hypomagnesemia, metabolic alkalosis, hypocalciuria

13

Liddle syndrome

AD, Gain of function mutation causing increased Na reabsorption in collecting tubules (increased activity of epithelial Na channel). Results in hypertension, hypokalemia, metabolic alkalosis, decreased aldosterone. Tx: amiloride

14

Syndrome of apparent mineralocorticoid excess

Hereditary deficiency of 11-beta-hydroxysteroid dehydrogenase, which normally converts cortisol into cortisone in mineralocorticoid receptor containing cells before cortisol can act on the mineralocorticoid receptors. Causes hypertension, hypokalemia, metabolic alkalosis. Low serum aldosterone levels.

15

Actions of angiotensin II (6)

1. acts at ATII receptors on vascular SM to cause vasoconstriction, 2. Constricts effect arteriole of glomerulus, 3. Increases aldosterone, 4. Stimulates ADH leading to H2O reabsorption, 5. Increases PCT Na/H activity, 6. Stimulates the hypothalamus (thirst)

16

How does the macula densa work?

Senses decreased NaCl deliver to DCT causes adenosine release, causes vasoconstriction

17

Where does Epo come from?

Interstitial cells in peritubular capillary bed

18

Where is vitamin D converted to its active form?

By the PCT cells

19

What do ADH and aldosterone regulate?

ADH regulates osmolarity, aldosterone regulares ECF volume and Na content

20

Effect of ANP

Causes increased GFR and increased Na filtration with NO compensatory Na reabsorption in distal nephron. Net effect: Na loss and volume loss

21

What causes K to shift out of cells?

Digitalis, hyperosmolarity, lysis of cells, acidosis, beta-blocker, high blood sugar (insulin deficiency) [DO LABS}

22

How do you monitor for too much magnesium?

DTRS (hypermagnesemia decreases DTRs), also causes lethargy, bradycardia, hypotension, cardiac arrest, and hypocalcemia

23

Respiratory compensation for metabolic acidosis

Winters formula. Pco2= 1.5[HCO3-] +8 +/-2

24

What can cause a metabolic alkalosis?

Loop/thiazide diuretics, vomiting, antacid use, hyperaldosteronism

25

What causes an anion gap metabolic acidosis?

MUDPILES: methanol, uremia, diabetic ketoacidosis, propylene glycol, iron tablets/isoniazid, lactic acidosis, ethylene glycol (oxalic acid), salicylates

26

What causes a normal anion gap metabolic acidosis?

HARD-ASS: hyperalimentation, addison disease, renal tubular acidosis, diarrhea, acetazolamide, spironolactone, saline infusion

27

Type 1 renal tubular acidosis

Distal, urine pH >5.5, defect in ability of alpha-intercalated cells to secrete H+ -> no new HCO3- is generated -> metabolic acidosis. Associated with hypokalemia, increased risk for calcium phosphate kidney stones (due to increased urine pH and increased bone turnover)

28

Type 2 RTA

Proximal, urine pH

29

Causes of type 2 RTA

Fanconi syndrome and carbonic anhydrase inhibitors

30

Causes of type 1 RTA

Amphotericin B toxicity, analgesic nephropathy, congenital anomalies (obstruction) of urinary tract